Silver loading is the term used for the insurer practice of inflating the premium charged for Affordable Care Act silver plans in order to pay for the expense of CSR (Cost-Sharing Reduction) Program versions of silver plans.
In response to the Trump decision to stop paying CSR payments, health insurers responded by inflating silver plan premiums. This inflation has significantly increased the premium for the benchmark plan, triggering much higher average PTCs. According to the Congressional Budget Office, silver loading has resulted in a net increase in federal spending because the growth in PTC payments due to inflated premiums has exceeded the amount that CSR appropriations would have cost taxpayers. In 2018, CBO predicted that CSR appropriations would reduce federal deficits by $29 billion over the period 2018–2027, mainly from smaller federal subsidies for insurance for people with income between 200 and 400% of poverty. CBO expects that prohibiting silver loading would reduce premiums for people who do not qualify for PTCs.
Additional Resources